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Molecular Breast Imaging: A Comprehensive Review.

Ashley I Huppe1, Anita K Mehta1, Rachel F Brem1

  • 1George Washington University, Comprehensive Breast Care Center, Washington, DC.

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|January 11, 2018
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Summary
This summary is machine-generated.

Molecular breast imaging (MBI), or breast-specific gamma imaging (BSGI), offers a physiologic approach to detect occult breast cancer, finding it in 9% of new diagnoses. This effective tool aids in high-risk surveillance and influences surgical decisions.

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Area of Science:

  • Nuclear medicine and radiology
  • Oncology
  • Medical imaging

Background:

  • Molecular breast imaging (MBI), also known as breast-specific gamma imaging (BSGI), is a physiologic imaging technique.
  • It complements anatomical methods like mammography and ultrasound for breast cancer detection.
  • MBI has been utilized in clinical practice for over ten years.

Purpose of the Study:

  • To provide a comprehensive overview of Molecular Breast Imaging (MBI).
  • To discuss the history, current literature, indications, and clinical integration of MBI.
  • To detail the approach to biopsy and its role in patient management.

Main Methods:

  • Review of existing literature on MBI/BSGI, citing over 300 studies.
  • Discussion of clinical indications and appropriateness criteria established by professional societies.
  • Analysis of MBI's performance in detecting various breast cancer types and its impact on surgical management.

Main Results:

  • MBI detects occult breast cancer in 9.0% of newly diagnosed cases.
  • It shows high sensitivity for high-risk lesions, detecting 98% of invasive cancers and 91% of ductal carcinoma in situ.
  • In high-risk surveillance, MBI detects cancer in up to 16.5 per 1000 women.
  • MBI influences surgical management in approximately 25% of newly diagnosed breast cancer patients.
  • Studies indicate that lower doses of 99mTc sestamibi (5-10mCi) are as effective as higher doses (10-20mCi).

Conclusions:

  • MBI is an effective adjunct for breast cancer screening, particularly in women with dense breasts and those at high risk.
  • It plays a crucial role in assessing treatment response and guiding surgical decisions.
  • Established guidelines and criteria support the integration of MBI into routine clinical practice.